` OFFICE OF THE AUDITOR GENERAL THE REPUBLIC OF UGANDA REPORT OF THE AUDITOR GENERAL ON THE FINANCIAL STATEMENTS OF WAKISO DISTRICT LOCAL GOVERNMENT FOR THE YEAR ENDED 30TH JUNE 2017 OFFICE OF THE AUDITOR GENERAL UGANDA TABLE OF CONTENTS LIST OF ACROYNMS ........................................................................................................ iii Key Audit Matter ............................................................................................................... 5 Utilization of Medicines and Medical Supplies...................................................... 5 Stock outs of Medicines and Health Supplies ...................................................... 6 Expired Drugs ............................................................................................................ 6 Under Staffing ............................................................................................................ 7 Emphasis of Matter........................................................................................................... 7 Unpaid Pension Arrears ............................................................................................ 7 Other Matter ...................................................................................................................... 8 Failure to Implement Budget as approved by Parliament .................................. 8 Low Recovery of Youth Livelihood Program Funds ............................................ 8 Mismanagement of Designated Areas .................................................................... 9 Forest Reserves ......................................................................................................... 9 Wetlands ..................................................................................................................... 9 Outstanding Utility Bills at Entebbe Hospital ....................................................... 10 Management’s Responsibility for the Financial Statements ..................................... 10 Auditor’s Responsibilities for the Audit of the Financial Statements ...................... 11 Appendices....................................................................................................................... 13 ii LIST OF ACROYNMS BOQ Bills of Quantities C/U Church of Uganda CAO Chief Administrative Officer DEO District Education Officer DLG District Local Government FY Financial Year GOU Government of Uganda HC Health Centre IFMS Integrated Financial Management System ISSAI International Standards of Supreme Audit Institution KCCA Kampala Capital City Authority KMs Kilometers LGFAM Local Governments Financial and Accounting Manual 2007 LGFAR Local Governments Financial and Accounting Regulations 2007 LGMSD Local Government Management and Service Delivery MMHS Management of Medicines and Heath Supplies MoFPED Ministry of Finance Planning and Economic Development MoH Ministry of Health NFA National Forestry Authority NMS National Medical Stores P/S Primary School PFMA Public Finance Management Act 2015 PPDA Public Procurement and Disposal of Assets UGX Uganda Shillings URF Uganda Road Fund UWEP Uganda Women Enterprise Project YLP Youth Livelihood Programme iii REPORT OF THE AUDITOR GENERAL ON THE FINANCIAL STATEMENTS OF WAKISO DISTRICT LOCAL GOVERNMENT FOR THE YEAR ENDED 30TH JUNE 2017 THE RT. HON. SPEAKER OF PARLIAMENT Opinion I have audited the financial statements of Wakiso District Local Government which comprise the Statement of Financial Position as at 30th June 2017, and the Statement of Financial Performance, Statement of Changes in Equity and statement of Cash flows together with other accompanying statements for the year then ended ,and notes to the financial statements ,including a summary of significant accounting policies. In my opinion, the financial statements of Wakiso District Local Government for the year ended 30th June 2017 are prepared, in all material respects in accordance with Section 51 of the Public Finance Management Act, 2015 and the Local Government Financial and Accounting Manual, 2007. Basis for Opinion I conducted my audit in accordance with International Standards of Supreme Audit Institutions (ISSAIs) and the National Audit Act 2008. My responsibilities under those standards are further described in the Auditor’s Responsibilities for the Audit of the Financial Statements section of my report. I am independent of the District Local Government in accordance with the Constitution of the Republic of Uganda (1995) as amended, the National Audit Act 2008, the International Ethics Standards Board for Accountants’ Code of Ethics for Professional Accountants (IESBA Code) together with the ethical requirements that are relevant to my audit of the financial statements in Uganda. I have fulfilled my other ethical responsibilities in accordance with these requirements and the IESBA Code. I believe that the audit evidence I have obtained is sufficient and appropriate to provide a basis for my opinion. 4 Key Audit Matter Key audit matters are those matters that, in my professional judgment, are of most significance in my audit of the financial statements of the current period. These matters were addressed in the context of my audit of the financial statements as a whole, and in forming my opinion thereon, and I do not provide a separate opinion on these matters. I have determined the matter described below as key audit matter to be communicated in my report. Utilization of Medicines and Medical Supplies The Management of Medicines and health Supplies Manual indicates that Medicines and health supplies form the second biggest expenditure in the health sector after human resources. The security of medicines must be ensured at all levels to prevent theft, abuse, misuse and wastage. Consequently in the course of auditing Wakiso District’s Financial Statements, I considered the utilisation of medicines and medical supplies as an area of focus. The audit focused on the procedures, processes, tools and documentation used to manage medicines and medical supplies which included; Involving external expertise in identifying the sample of tracer medicines and medical supplies, and developing data collection tools. Selecting medicines and medical supplies to trace their utilization in the hospital. Analysing the delivery cycles, balances on stock cards and order levels to ascertain stock outs. Obtaining and checking the records relating to the expired medicines and also inspecting the storage practices. Establishing the availability of key human resource personnel to ensure that medicines and medical supplies are not wasted as explained in the Management of Medicines and medical Supplies Manual. I obtained the approved structure and compared it with the list of existing staff. 5 The audit involved the assessment of management of Medicines and Health supplies at Entebbe hospital, Buwambo HC IV, Namayumba HC IV and Wakiso HC IV and made the following observations; Stock outs of Medicines and Health Supplies Part 3 of the Management of Medicines and Health Supply’s (MMHS) manual requires that management establishes policies, procedures and techniques to maintain an optimum amount of stock of each item at all Health Facilities to minimize stock outs and expiry. I analyzed the delivery cycles, balances on stock cards. I observed that 5 items out of the 11 (eleven) selected indicator EMHS experienced stock outs within the audit period. Noticeably Mama Kits were out of stock for 103 days and coarten for 63 days at Entebbe Hospital. The stock out may be a result of failure by NMS to supply drugs in the quantities ordered by Health centres and lack of reliable information on drugs usage and stocking positions. The stock outs; erodes patient confidence in the health sector which leads patients to explore alternative and inappropriate and expensive systems of health care. The Accounting Officer explained that during the period under review there was a general stock out of Mama kits at NMS but indicated that supply for the same had resumed. He further explained that replenishment of stocks is pre-determined by NMS delivery schedule(Cycle system). The Accounting Officer should liaise with NMS to ensure continuous optimum stock of medicines and supplies. Expired Drugs Part 9 – of the Management of Medicines and Health Supplies (MMHS) manual requires that expired items should be properly recorded, placed in a designated area and destroyed in accordance with the local regulations. I obtained and checked the records relating to the expired medicines and also inspected how they are stored. I observed that units of assorted expired essential medicines and health supplies had expired and had not been destroyed as shown in appendix 1(a), 1(b) and 1(c). The controls over expired drugs are not functioning as intended .This can result in the expired drugs getting redistributed to the market . 6 The Accounting Officer attributed expiry of medicines to delivery of medicines not ordered for short expiry dates and low consumption of the medicines. I advised the Accounting Officer to liaise with NMS and have expired drugs disposed of. Under Staffing I obtained the approved structure and compared it with the list of existing staff. it was observed that out of 48 approved positions, only 17 (35%) posts were filled, leaving 31 (65%) posts vacant at Buwambo HC IV while out of 16 approved position, only 4 posts (25%) posts were filled, leaving 12(75%) posts vacant at Wakiso HC